If you are new to the forums, you must register a free account before you can post. The forums have a separate registration from the rest of www.chronofhorse.com, so your log in information for one will not automatically work for the other. Disclaimer: The opinions expressed here are the views of the individual and do not necessarily reflect the views and opinions of The Chronicle of the Horse.

Mystery Lameness... Help!

Help please! My horse has been lame for just over 2 months now and the prognosis seems to be getting worse and I don’t know what to do. Has anyone experienced anything similar or know of any similar cases?

The Horse
Age: 8
Breed: Warmblood
Height: 17.3h
Performance Level: Horse has been in a program since 5. I bought the horse at the age of 6 and has now been in competition for a solid year (show season ended in October) ending competitively at 1.20M with the potential for 1.40M+.

The Timeline
February 8th – Horse slightly unsound on the right front at the walk. With some slight exercise at the walk and a small amount of trot, his soundness at the walk improves. This light exercise twice daily continues.

February 18th – Horse very unsound now, with any exercise there is heat in the right pastern and fetlock. Horse is put on stall rest with 15 minute hand walks in the arena twice daily.

February 22nd – The vet comes and does another lameness exam; the horse is unsound in the corners and especially tracking to the left. The vet conducts a ultrasound on the right front and determines that there might be a strain on the collateral ligament (MCL) however it appears to be slight. The horse continues with stall rest with 20 minute tack walks in the arena tracking to the right.

March 1st – Trotting down the straight line in the arena is added to the talk walks, beginning with 10 long sides and progressing to 20 long sides by the end of the week. By the weekend the horse is feeling good, however keeping the rearing and bucking at bay is proving to be difficult.

March 8th – Following the weekend, the horse appears to be unsound and heat is evident in the right pastern and fetlock . The vet comes out and determines that the leg has not improved to a point of stability. The horse is blocked at the coffin joint and this improves lameness dramatically. The coffin joint is injected with a small dose of hyaluronic acid to reduce inflammation (heat) to allow for natural healing. The hyaluronic acid dose is expected to least for 6 weeks, the horse is to return to the control program of 20 minute hand walks and tack walks in the arena tracking to the right. In addition the horse will have Omega Alpha Chill before exercise to keep playfulness in control.

March 15th – Horse appears sound and continues with the control program. The vet conducts some xrays on the right front to eliminate other causes of lameness, xrays are clean.

March 22nd – Horse has started to appear lame at the walk, but sound at the trot. The vet conducts a lameness exam and has determined that the issue is not in the right front but is in the left front shoulder. The vet believes the left front shoulder is not extending properly and that some stretching should improve. The vet also recommends that perhaps some light alternative therapy could be added, such as massage or acupuncture. The vet prescribed the horse Isoxsuprine to increase circulation to assist in healing.

March 29th – An acupuncturist vet conducts a lameness exam and determines that, while the horse appears totally sound at the trot in both directions, at the walk the horse appears to move the left front shoulder normally but when it comes time to put pressure on the hoof landing, the shoulder shifts backwards in avoidance. The acupuncturist vet determines this movement is resulting not from lameness but from a nerve issue in the shoulder. The acupuncturist vet begins the first round of regular acupuncture with a chiropractic massage of the left front shoulder. The horse is prescribed thiamine. The horse’s blood is taken for testing, not sure what tests were conducted but the tests came back clean.

March 31st – The horse’s soundness at the walk improves, especially if a small amount of trot on the long sides tracking to the right is added. The horse continues with 20 minute tack walks with 10 longsides of trot both tracking to the right twice daily.

April 5th – The acupuncturist vet conducts the first more intensive round of electro acupuncture. We plan on 2-3 more sessions over the next couple weeks. The main vet is kept up to date and approves of the current plan of action.

April 8th – The horse’s walk continues to improve, the horse appears sound at the trot. However, something does not feel right with the horse’s trot on the right front again, but the horse appears sound even tracking to the left and into the corners. Following exercise there was heat in the right pastern and fetlock.

At this point we are now waiting for the main vet to come out again next week and I have put the horse back to a control program of 20 minute hand walks twice daily.

.

I had simular experience. First walk is not symetrical gait a lame horse will show some irregularity at the trot if they are lame. Have you gotton a second opinion?

Find the best vet hospital surgeon/specialist and get a second opinion. Don't work the horse this does sound like it could be a medial collateral ligament injury. What you may need MRI if you can afford it. Sometimes you need to inject and rest then start a very slow rehab with months of just walking. With my horse medial collateral ligament desmitis people thought he was "shoulder lame". One of my equine vets with over 25 years experience also thought my horse could be shoulder lame. The specialist in sports medicine and surgery was able to iscolate a pastern injury. Initially we rested in small paddock with hand walking for months which didn't help much. After a pastern injection only caused three weeks improvment we got an MRI and main problem was collateral ligament injury of the pastern. If none of the blocks help then you may spring for a bone scan.

Assuming you've x-rayed everything - what do they look like? No OCD I hope? I'd also consider starting with a bone scan and then move to an MRI. If a vet can't decide what's wrong then it's time to move up the food chain and seek out a more experienced vet preferably one that specializes is sports medicine that see's cases like yours on a daily basis.

I would say do not mess around with this. If the horse has not been improving for this length of time, stop working and send the horse to a reputable clinic/do what Fharoah said. Definitely get a bone scan to pinpoint the problem (if the vets also believe that is the way to go).

I just had to send one of mine to New Bolton. It was an expensive trip, ended up with bone scan and ultrasound, but it was well worth knowing the actual cause instead of hemming and hawing and guesswork that did not give us a clear view of the problem and a plan for recovery. I am confident that in the end the trip to the clinic will be less expensive and far more beneficial to the horse than continued guesswork at home.

I recommend always starting with insuring internal hoof balance and coffin joint alignment ....evaluted via radipographs properly set up specifically for that purpose. (different from taking them just to look for bone abnormalities) And eased breakover ALL AROUND the hoof to take stress off the collateral ligamants and coffin joints.